Composition

Each 100 ml contains: 67 g Lactulose.

Properties

Duphalac is a synthetic disaccharide which is used in the treatment of constipation and to reduce blood ammonia levels in portal-systemic encephalopathy. When taken by mouth Duphalac is not affected by disaccharidase in the small intestine and therefore not absorbed.

In the colon Duphalac is broken down by saccharolytic bacteria into acetic, formic and lactic acids. The acids result in an increase in osmotic pressure and slight acidification of the colonic contents. This in turn causes an increase in stool water content, softens the stool and stimulates bowel movements.

When larger doses are given, the pH in the colon is reduced sufficiently to cause a decrease in absorption of ammonium ions and other toxic nitrogenous compounds, so that the blood ammonia concentration falls in patients with hepatic encephalopathy.

Indications

Constipation (may take up to 48 hours to act).
Hepatic encephalopathy (for the prevention and treatment of portal-systemic encephalopathy).

Dosage

Expressed in terms of the syrup containing Duphalac 3.35 g/5 ml (dose may be mixed with milk or fruit juice to improve flavour).

Constipation

Adults

Initially 15 ml (one tablespoonful) twice daily gradually reduced according to patient’s needs.

Children

Under 1 year: 2.5 ml twice daily.
1 To 5 years: 5 ml (one teaspoonful) twice daily.
6 To 12 years: 10 ml twice daily gradually reduced.

Hepatic encephalopathy

30 To 50 ml 3 times daily, subsequently adjusted to produce 2 To 3 soft stools daily.

Contraindications

Galactosaemia and intestinal obstruction.

Side effects

Duphalac may produce gaseous distention with flatulence and abdominal discomfort, such as cramping in about 20% of patients. Excessive dosage may produce diarrhoea. Nausea and vomiting have been reported infrequently.

Precautions

As the syrup contains also small quantities of galactose and lactose, it should be used with caution in diabetics and patients on galactose-free diet (galactosaemia).

Storage

Store at room temperature (15 To 30°C) and away from direct light. A normal darkening of colour may occur, this does not affect therapeutic action.
Keep out of reach of children.

Presentation

Bottles of 120 ml, 200 ml & 300 ml.